DR. JOSE PUGLIESE M.D.
NPI 1861434532
Psychiatry & Neurology - Psychiatry in Glen Cove, NY

NPI Status: Active since June 10, 2006

Contact Information

70 GLEN ST
SUITE 102
GLEN COVE, NY
ZIP 11542
Phone: (516) 609-9294

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  • Individual
  • Male
  • Years of Experience 43
  • Psychiatry & Neurology
  • Psychiatry
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JOSE PUGLIESE

This page provides the complete NPI Profile along with additional information for Jose Pugliese, a provider established in Glen Cove, New York with a medical specialization in Psychiatry & Neurology, focusing in psychiatry and more than 43 years of experience. The healthcare provider is registered in the NPI registry with number 1861434532 assigned on June 2006. The practitioner's primary taxonomy code is 2084P0800X with license number 197269 (NY). The provider is registered as an individual and his NPI record was last updated 12 years ago.

NPI
1861434532
Provider Name
DR. JOSE PUGLIESE M.D.
Gender
Male
Entity Type
Individual
Location Address
70 GLEN ST SUITE 102 GLEN COVE, NY 11542
Location Phone
(516) 609-9294
Mailing Address
7 SUGAR MAPLE CT DIX HILLS, NY 11746
Mailing Phone
(631) 254-6976
Medical School Name
OTHER
Graduation Year
1983
Is Sole Proprietor?
Yes
Enumeration Date
06-10-2006
Last Update Date
11-12-2014
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A psychiatrist like Jose Pugliese are primary mental health physicians diagnose and treat mental illnesses through psychotherapy, psychoanalysis, hospitalization and medication. Psychiatrist help patients find solutions through changes in their behavioral patterns, explorations of experiences, group and family therapy.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychiatry & Neurology Psychiatry

Taxonomy Code
2084P0800X
Type
Allopathic & Osteopathic Physicians
License No.
197269
License State
NY
Taxonomy Description
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
53M261MEDICARE ID-TYPE UNSPECIFIED (04)NY 
G04399MEDICARE UPIN (02)NY 
02491147MEDICAID (05)NY 

Medicare Participation & PECOS Enrollment Status

Jose Pugliese is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jose Pugliese is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7214993617

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20041207001153

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 298 times for 48 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 125 times for 28 patients

Psychiatric diagnostic evaluation with medical services

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

This service was performed 19 times for 19 patients

Psychotherapy with evaluation and management visit, 30 minutes

Psychotherapy with evaluation and management is a 30-minute session where a mental health professional talks with you about your concerns and feelings. They assess your mental health, provide support, and manage your treatment plan to help improve your well-being.

This service was performed 115 times for 25 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $50.88 for a new patient copayment and $20.86 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 11542 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

  • Average New Patient Price $203.53
  • Minimum New Patient Price $67.4
  • Maximum New Patient Price $203.53
  • Average New Patient Copayment $50.88
  • Minimum New Patient Copayment $16.85
  • Maximum New Patient Copayment $50.88

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $83.44
  • Minimum Established Patient Price $21.66
  • Maximum Established Patient Price $164.45
  • Average Established Patient Copayment $20.86
  • Minimum Established Patient Copayment $5.41
  • Maximum Established Patient Copayment $41.11

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1861434532, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
1
Unchanged
Pos 5
4
Doubled → 8
Pos 6
3
Unchanged
Pos 7
4
Doubled → 8
Pos 8
5
Unchanged
Pos 9
3
Doubled → 6
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 4 → 8 4 → 8 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 1 + 2 + 1 + 8 + 3 + 8 + 5 + 6 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1861434532.

Other Providers at the Same Location


The following 19 providers are registered at the same or a nearby location.

Internal Medicine (Cardiovascular Disease)
70 GLEN ST, SUITE 200
GLEN COVE, NY 11542
Internal Medicine (Cardiovascular Disease)
70 GLEN ST, STE 200
GLEN COVE, NY 11542
Physical Medicine & Rehabilitation
70 GLEN ST, SUITE380
GLEN COVE, NY 11542
Chiropractor (Orthopedic)
70 GLEN ST, SUITE 380
GLEN COVE, NY 11542
Podiatrist
70 GLEN ST, SUITE 380
GLEN COVE, NY 11542
Chiropractor
70 GLEN ST, SUITE 380
GLEN COVE, NY 11542
Preventive Medicine (Preventive Medicine/Occupational Environmental Medicine)
70 GLEN ST, SUITE 300
GLEN COVE, NY 11542
Physical Therapist (Orthopedic)
70 GLEN ST, SUITE 380
GLEN COVE, NY 11542
Allergy & Immunology
70 GLEN ST, SUITE 300
GLEN COVE, NY 11542
Ophthalmology
70 GLEN ST, SUITE 380
GLEN COVE, NY 11542
Audiologist-Hearing Aid Fitter
70 GLEN ST, SUITE 100
GLEN COVE, NY 11542
Audiologist-Hearing Aid Fitter
70 GLEN ST, SUITE 100
GLEN COVE, NY 11542
Physical Medicine & Rehabilitation
70 GLEN ST, STE 101
GLEN COVE, NY 11542
Clinic/Center (Medical Specialty)
70 GLEN ST, SUITE 380
GLEN COVE, NY 11542
Psychiatry & Neurology (Psychiatry)
70 GLEN ST, SUITE 101
GLEN COVE, NY 11542
Podiatrist
70 GLEN ST, SUITE 380
GLEN COVE, NY 11542
Massage Therapist
70 GLEN ST
GLEN COVE, NY 11542
Physical Therapist
70 GLEN ST
GLEN COVE, NY 11542
Internal Medicine (Cardiovascular Disease)
70 GLEN ST, SUITE 200
GLEN COVE, NY 11542

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1861434532, enumerated as an "individual" on June 10, 2006.

The provider is located at 70 GLEN ST SUITE 102 GLEN COVE, NY 11542 and the phone number is (516) 609-9294.

Psychiatry & Neurology with taxonomy code 2084P0800X and a focus in Psychiatry.

The provider might be accepting Accepts: Providence Health Plan, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.